Zanfel™
Wednesday, April 02, 2008
Paul Auerbach, M.D.
Poison ivy (oak and sumac) season will soon arrive, and much will be written in the press about remedies for the itchy rash caused by exposure to urushiol, the resin found in these plants. In addition to the standard method of washing with soap and water, there are commercial products touted to facilitate physical removal of the oily resin, which theoretically reduces the exposure and lessens the skin reaction.
One such product is Zanfel™ Poison Ivy, Oak & Sumac Wash. Zanfel™ is sold in 1 ounce tubes, and is advertised to carry a 10 year shelf life. Instructions for use direct the user to:
1. Wet the affected area.
2. To treat a surface area of skin approximately the size of an adult hand or face, squeeze 1 and 1/2 inches of Zanfel™ from the tube into the palm of a hand. Do not use less than this amount.
3. Wet and rub both hands together for 10 seconds, working the Zanfel™ into a paste. This activates the ingredients.
4. Using both hands, rub the activated Zanfel™ onto the affected skin for 3 minutes or until there is no itching.
5. Rinse the area thoroughly with running water.
6. If itching returns, repeat the process.
The manufacturer states that Zanfel™ is "safe and effective during any stage of the allergic reaction," is "safe for face and genitals," and is "safe for children and pregnant or nursing women."
Zanfel™ is a soap mixture of ethoxylate and sodium lauroyl sarcosinate surfactants. When "activated" (worked into a paste that can be spread effectively on the skin), the soap is able to bind urushiol and thus allow it to be removed from the skin by rinsing.
Zanfel™ is unique with respect to poison ivy/oak/sumac remedies in that it is supposed to remove resin from the skin after the rash has appeared. In one study, this effect was present even at 144 hours post exposure. However, it seems logical that at some point post exposure, urushiol is no longer present in the skin and that the allergic contact dermatitis (manifested as redness, itching, swelling, and blisters), would not be lessened by Zanfel™, unless it has some direct anti-inflammatory properties. The exact duration of the period during which Zanfel™ would be expected to be effective has not been determined, but its effectiveness is likely greatest nearest the time of initial exposure to urushiol. It is possible that used within the first few hours of exposure, a reaction might be prevented.
It should be noted that relative to many other drugs and remedies on the market, there are few clinical studies using Zanfel™. While the data referenced by the company are supportive, it is possible that repeat or larger studies might be less conclusive. That having been said, there does not seem to be any harm in using this product, and there may be significant benefit. The user is cautioned that no therapy, including Zanfel™, is infallible, so that if a person suffers a serious reaction to poison ivy, oak, or sumac, physician attention may be necessary. The most potent treatment currently available is high-dose steroid administration, which should be done under the guidance of a medical professional, unless one is far from help (e.g., in the wilderness).
Anecdotally, a few of my medical colleagues have used Zanfel™, both for themselves and for patients, and have found it to be effective, in that they believe that the reaction to a known poison oak/ivy/sumac plant(s) has been lessened (in comparison to what they would have expected), and in some cases halted, after application of the product. Other providers, like myself, await their first opportunity to use Zanfel™.
Preview the 25th Anniversary & Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 25-30, 2008.
Tags: Zanfel, poison oak, poison ivy, poison sumac, urushiol, wilderness medicine, outdoor medicine, healthline
13 Comments:
At Sun Oct 19, 07:46:00 AM 2008,
Anonymous said…
I find it annoying that the manufacturer insists that each application amount must be exactly 1.5 inches from the tube - even to the extent of providing a 1.5-inch "ruler" on the box and warning that the product won't work if less than 1.5 inches is used. This strikes me as a purely a marketing ploy to persuade customers to use more than they need, to use up the costly tube sooner than necessary. The instructions offer no rational explanation as to why each amount must be 1.5 inches, no matter the size of the rash. If the amount of cream is so critical, then it would seem to be more reponsible to offer it in individual treatment packets.
At Mon Oct 20, 04:13:00 PM 2008,
J said…
Totally agree... $40.00 an ounce!
At Mon Mar 23, 01:59:00 PM 2009,
Anonymous said…
Worth every penny if you have a severe reaction. I have used it and found it lessens the duration of the dermatitis. Short of oral steroids, I've not found a better treatment.
At Fri May 08, 09:40:00 AM 2009,
jbm said…
I have had an outbreak on my arm for the last 5 days. It continued to get worse and spread day after day. I would wake up in the middle of the night with my arm hurting and itching.
I tried all types of stuff and today finally broke down and purchased "Zanfel".
Got in the shower with it, and now 3 hours later my arm almost looks healed. No more drainage, No more pain, No more itching.
I totally agree with the other poster, "Worth every penny!"
At Mon May 11, 04:56:00 PM 2009,
Anonymous said…
Well, even though the cost is high, it does relive the itch. It doesn't seem to "heal" the poison ivy, but it stops the itch from driving you crazy.
As to the 1.5 inches, that does seem to be a marketing ploy to make you use more. I found that wetting the area and then applying a pea sized amount and rubbing it in for 20-30 seconds works best. A little more on a big spot. Definitely worth it.
At Tue May 12, 02:52:00 PM 2009,
PS said…
I got a fairly substanial rash on both forearms following two days of yard work. For the sake of science, I used Zanfel on one arm but not the other.
I made the application about 24 hours after exposure, after the initial stages of what would become hefty rash had started. The Zanfel arm seemed to have about 50 percent fewer blisters and rash.
Subsequent washes (at 36 and 48 hours post exposure) did little to prevent/shorten the rash and failed to remove areas where large blisters or rashes had broken out.
My conclusion: worthy every penny if you can afford it and catch the rash in time, but not a cure-all.
At Wed May 27, 05:43:00 PM 2009,
Anonymous said…
Wow - just used this today on my 5yo with poison ivy on both arms and legs. The itching stopped almost immediately and the rash was gone by dinnertime including two pretty severe patches). The $40 price tag is tough to swallow, but ultimately worth every penny.
At Tue Jun 02, 01:02:00 PM 2009,
Beauregard said…
Save your money and buy Mean Green handscrub. The formula and active ingredients are practically the same, but you can buy 64 ounces of the hand scrub for comparable cost of 1 ounce of Zanfel.
At Thu Jun 11, 02:39:00 AM 2009,
Anonymous said…
Wow! I bought this product only because my son was in agony. Within a day, the rash had completely disappeared, making me wonder if I had misdiagnosed. Then my husband got poison oak. Normally he has a very severe reaction, but after using the Zanfel for just 1 day, his rash not only failed to spread, but appeared to look substantially better. It was gone in only 2 days, a small miracle for him. This product, though carrying a steep price, is worth the money if you want results!
At Mon Jul 06, 01:47:00 PM 2009,
Anonymous said…
I have struggled with Poison Ivy for most of my life and have tried every possible remedy, from pills and creams and what not. I have been on the steroid packets at least 8 times in my life. In essence I am heavily allergic to the plant and its oils. I was told of Zanfel by a colleague about 5 years ago and I am truly shocked at its effectiveness. For me, it has worked exactly as advertised. After it’s use, the rash immediately feels better, to the point where you can actually touch or rub the rash and it will not itch. Occasionally with severe outbreaks I have had to use a second, third, or even fourth application. But it makes the rash VERY manageable, definitely shortens the duration of the allergic reaction substantially, and within 48 hours it is practically gone. It's true that $40 an ounce is expensive, but from where I sit the product is a Godsend!
At Thu Jul 09, 09:55:00 AM 2009,
Kris said…
Mango sap has urushiol, the same goodness found in poison ivy, oak, sumac, etc. I have never been allegric to mangoes and have picked them from my tree in my yard yearly and have eaten them without problems. This year as I approach 31 years young, I picked about a dozen mangoes to set out to ripen up. 3 days later I had a rash on my body where I held the mangoes against me.
Doctor prescribed a corticosteroid cream along with an antihistamine. Two days later, the rash worsened. The doctor then gave me a shot of cortisone which then swelled my eyes shut.
Last night, which is the 7th day I have been fighting this rash, I ran into some Zanfel. The price is definitely a hard sell, but I needed relief. Be it psychological, be it that the urushiol has run its course, or be it that Zanfel works, I woke up this morning with a significantly less area of rash and less itching.
For the folks commenting about the "exactly 1.5 inches", who knows the rationale, however, some chemicals must be mixed precisely to be effective. A simple epoxy to fix affix the handle on your favorite coffee mug requires a certain amount of the two ingredients with proper mixing or else the chemical reaction to form the solid bond will be less effective/adhesive/strong (pick your term). I'm not sure it's a marketing ploy or not, but I would drop the $40 again on it.
At Thu Jul 09, 01:01:00 PM 2009,
Anonymous said…
WHERE CAN I BUY MEAN GREEN SOAP FOR POISON INY/OAK ?
At Wed Jul 29, 07:06:00 AM 2009,
Anonymous said…
I hesitated when at Target and heard the price.......I was right!! Less than 24 hours later, the Zanfel is GONE and the poison ivy is still there!!!! A trip to Dr. would have been a $10/co-pay, and calamine and Benadryl would have been another $10.00.
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